Individual
DR. STEPHEN J GLAWSON SR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
400 MADISON AVE, LAKEWOOD, NJ 08701-3214
(732) 363-0800
(732) 367-5206
Mailing address
1403 HOLMES AVE, TOMS RIVER, NJ 08753-6925
(732) 363-0800
(732) 367-5206
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
15866
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15866
STATE LICENSE
NJ
Enumeration date
03/03/2006
Last updated
07/08/2007
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